Mäkäräinen L, Ylikorkala O
Am J Obstet Gynecol. 1984 Nov 15;150(6):765-8. doi: 10.1016/0002-9378(84)90682-3.
Production of the antiaggregatory and vasodilatory prostacyclin (prostaglandin I2) and the proaggregatory and vasoconstrictory thromboxane A2 during human labor was studied by measuring serial concentrations of the stable metabolites of these prostanoids, 6-keto-prostaglandin F1 alpha and thromboxane B2, respectively, in the amniotic fluid of 43 parturients whose labor was induced by amniotomy. The concentration of 6-keto-prostaglandin F1 alpha at amniotomy in 28 healthy parturients (92.7 +/- 12.1 pg/ml, mean +/- SE) was higher (p less than 0.02) than that in 15 preeclamptic women (48.6 +/- 5.5 pg/ml). The concentration of thromboxane B2 at amniotomy was 292.4 +/- 56.1 pg/ml, with no difference between the healthy and preeclamptic parturients. Both prostanoid levels rose consistently during labor, reaching peak levels when the cervix was fully dilated, but this rise started only after the established uterine contractility. Epidural anesthesia and paracervical blockade had no effect on 6-keto-prostaglandin F1 alpha and thromboxane B2 in the amniotic fluid, whereas oxytocin infusion was accompanied by reduced levels of thromboxane B2. The rise in amniotic fluid 6-keto-prostaglandin F1 alpha was reduced at every stage of labor in the preeclamptic women (n = 15), and its maximal increase (112.4 +/- 28.3 pg/ml) was smaller (p less than 0.005) than in the healthy women (n = 28, 240.8 +/- 21.4 pg/ml). The ratio of 6-keto-prostaglandin F1 alpha to thromboxane B2 also shifted to thromboxane B2 dominance in the preeclamptic parturients. It is concluded that a relative prostacyclin deficiency deteriorates in preeclamptic women during labor.
通过分别测定43例因人工破膜引产产妇羊水内这些前列腺素稳定代谢产物6-酮-前列腺素F1α和血栓素B2的系列浓度，研究了人类分娩过程中抗聚集和血管舒张性前列腺素I2（前列环素）以及促聚集和血管收缩性血栓素A2的产生情况。28例健康产妇人工破膜时6-酮-前列腺素F1α的浓度（92.7±12.1 pg/ml，均值±标准误）高于15例先兆子痫妇女（48.6±5.5 pg/ml，p<0.02）。人工破膜时血栓素B2的浓度为292.4±56.1 pg/ml，健康产妇和先兆子痫产妇之间无差异。两种前列腺素水平在分娩过程中均持续升高，在宫颈完全扩张时达到峰值水平，但这种升高仅在子宫收缩确立后才开始。硬膜外麻醉和宫颈旁阻滞对羊水中6-酮-前列腺素F1α和血栓素B2无影响，而静脉滴注缩宫素时血栓素B2水平降低。先兆子痫妇女（n = 15）在分娩的各个阶段羊水中6-酮-前列腺素F1α的升高均降低，其最大增加值（112.4±28.3 pg/ml）小于健康妇女（n = 28，240.8±21.4 pg/ml，p<0.005）。在先兆子痫产妇中，6-酮-前列腺素F1α与血栓素B2的比值也转向以血栓素B2为主。结论是，先兆子痫妇女在分娩过程中相对前列环素缺乏会恶化。
